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New Delhi, May 29: A new study published in the Lancet on accelerating decline in the deaths of children under 5 between 2000 and 2010 as compared to 1990-2000 has got its figures wrong on India, says Save the Children.
According to the report, across 21 regions of the world, rates of neonatal, post-neonatal, and childhood mortality are declining. The study also claims that worldwide, the deaths of children under 5 have dropped from 11.9 million deaths in 1990 to an estimated 7.7 million deaths in 2010. Using a technique called Gaussian Process Regression, the authors of the study claim that under-five mortality in India has come down from 84.6 per 1000 live births in 2000 to 62.6 in 2010. “This would mean a 22 per 1000 decline in under-five mortality which is incredibly good news. Unfortunately, this is a misleading picture of the reality as demonstrated by Government of India statistics,” Thomas Chandy, CEO, Save the Children, said.
“The authors of the study have used a technique that works better at providing estimates where there is limited or no data. The just released Sample Registration System Statistical Report 2008 (Government of India report) places under-five mortality in India at 69 per 1000 live births. The SRS 2008 findings, which are matched by Unicef estimates, are based upon a large sample size of 7.10 million population in India as a whole with even the small States given a coverage of more than 100,000. “The sample size of the SRS, which is arguably the largest in the world, helps provide robust estimates of health indicators and is more acceptable than an extrapolated figure arrived at by the study which is seven points less,” Chandy said.
By adopting a lower and unsubstantiated rate of under-5 mortality, we are, in effect, underreporting the deaths of several hundred thousands of children. “Believing that we have made a rapid decline in reducing the deaths of children under 5 will lead to a false sense of complacency. This would be foolhardy at a time when we should be stepping up our efforts to prevent the needless deaths of children under 5. If saving the lives of millions of children were seen as less of a problem, budgetary commitments to the issue will slacken,” Chandy warned.
According to UNICEF and SRS estimates, 1.83 million children under 5 die every year in India. But on the basis of the study published in the Lancet, which projects an accelerated decline in under-5 mortality, only 1.64 million under 5 children die annually in India.
The implication of an accelerating decline in under-five mortality would mean that India is on track to meeting Millennium Development Goal 4. Unfortunately, this is not the case now. Globally, it is estimated that an annual rate of decline of 4.4 per cent is needed to reduce the deaths of children under 5 by two-thirds by 2015. In India, the annual rate of decline in child mortality between 1990 and 2008 is 2.25 per cent, not 3-4 per cent as indicated by the study. As per the 2015 target, India needs to reduce under-5 mortality to 39/1000. The required rate of decline from 2009 to 2015 per year has gone up to 6.28 per cent (Table 1).
“While some progress has definitely been made in India, especially by schemes such as the NRHM, we have a long way to go,” Chandy said. “The good schemes in place need to be matched by effective implementation. And there is enough experience in India proving that low-cost interventions can make the difference between life and death for a child.”
Under-5 Mortality per 1000 and Rate of Reduction;
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1990
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2008
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2015
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Under -5 Mortality Rate
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116
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69
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39
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Current Annual rate of reduction (%)
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2.25
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Required rate of reduction from 2009 to 2015 (%)
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6.28
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